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Runners pay the price for quick change of pace

Concerned with the injury risks facing amateur fitness freaks, a kinesiology expert from University of Toronto advises "to train to run before you run to train."

As a new runner, Marissa Wener lost a whole season to Achilles tendinitis. "I just wanted to keep going further," she said. A new passion for running can often bring with it sudden knee pain or a swollen foot, sidelining some for weeks or even months. (Vince Talotta / Toronto Star)

Marissa Wener had always been active with sports but thought the Nike Women’s 15k held this June sounded cool after seeing the race promoted on Instagram and Facebook.

This spring, she jumped from running five kilometres before work to weekend runs of 12 kilometres or more, which she called “a huge mistake.”

“I just wanted to keep going further,” said Wener, 24.

But just before the June race, she blew out both heels in a bout of Achilles tendinitis, dashing a summer running season and any faint hopes of a half-marathon this fall. It was painful just to put her feet on the floor in the morning. After months, she’s finally healed but only has time for a few fall runs before putting her shoes away for the winter.

“Once it starts getting nice out, I’m going to give it a go, but do it properly this time around,” she said.

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With so many friends posting Instagram photos of a running route by the lake and #crewlove photos of new spandex-clad pals gripping a bagel and a medal at a finish line, it’s tempting to think “I can do that.”

Social media has inspired a mainstream boom in distance running, but a new passion for the sport can often bring with it sudden knee pain or a swollen foot, sidelining newbie runners for weeks or even months.

“In the last five to seven years, we are probably seeing double the number of runners’ injuries,” said Adam Brown, a physiotherapist for 13 years.

“There are more runners and the vast majority of them are amateurs,” said Brown, also a runner himself. Though all runners will likely get hurt at some point, studies have shown that newer runners are more prone to injury, mostly from increasing mileage too fast. Some runners have poor form as well, like rolling the foot too far outward or knees too far inward.

“I think social media has encouraged people to just take it on, on their own,” Brown said. “What that means is a variety of training errors occur. If nobody ever looks at the way you run and makes form suggestions, there’s a risk you’re running poorly, which is the next biggest reason we have runners’ injuries.”

Ten years ago, when the Scotiabank Toronto Waterfront Marathon had 9,647 participants, runners were still a strange breed: serious loners or huddled in packs at dawn on Sundays. Many were part of members-only clubs or joined marathon clinics with fairly strict training regimens.

This year 28,000 runners were expected, including hardcore competitors, charity runners and what Canada Running Series race director Alan Brookes calls “healthy-lifestyle runners.”

The new interest in running is caused in part by millennials, Brookes said, adding that demographic is more likely to join a loose crew than a group with formal coaching.

"Races are getting better at marketing themselves and hyping up would-be participants," says chiropractor Kris Sheppard, "but that means they could be seriously underprepared when race day comes around."
(Lucas Oleniuk)

The boom is also what led Toronto chiropractor Kris Sheppard to open the Runner’s Academy in 2014. Races are getting better at marketing themselves and hyping up would-be participants, but that means they could be seriously underprepared when race day comes around, he said.

“We started because we were seeing a lot more people running and they were running into issues,” Sheppard said. “The biggest issue with people getting injured is ramping up too quickly.”

A 2014 study in the Journal of Orthopaedic & Sports Physical Therapy found runners who increased less than 10 per cent over two weeks were less likely to get injured than more ambitious counterparts.

“You need to train to run before you run to train,” said David Frost a University of Toronto kinesiology professor, biomechanics expert and coach who recommends “baby steps” and ensuring proper alignment.

Though no body keeps track of injuries, “with more people becoming active and getting involved in running races, we are also seeing an increase in the number of people getting hurt while training,” Frost said.

Running into pain

Though many runners will eventually become injured, the five most common running injuries can mostly be prevented by appropriate strength training, a gradual increase in mileage and proper running form.

Achilles tendinitis. This repetitive-strain injury occurs when the body’s largest tendon, which connects the heel to the calf, begins to break down and becomes inflamed. It can thicken and cause swelling, or even calcify and harden. It is typically caused by a sudden increase in distance or intensity, as well as tight calves — another common problem in runners. Recovery time can be several months and treatment includes rest, ice and calf stretches.

Plantar fasciitis. The long, thin band of ligament known as the plantar fascia that supports the arch of the foot can become inflamed with overuse, causing severe pain in the heel. High arches, new or increased activity, and tight calves can lead to inflammation and stiffness. Recovery time can be several months or even a year, and recurrence is common. Treatment includes rest, ice, and calf and arch stretches, especially in the morning.

Runner’s knee. Also known as Palletofemoral Pain Syndrome, the telltale symptom is sharp pain around or behind the kneecap. It can be caused by poor tracking of the kneecap over the thigh and shin bones, as well as damage to the tendons and soft tissues around the knee joint. In runners, the common cause is overuse or a sudden increase in mileage. Treatment often requires physical therapy and toning the quadriceps and hamstring muscles.

Iliotibial band (IT band) friction syndrome. Another overuse injury, the repetitive flexing and extending of the IT band, which runs along the outside of the leg from the pelvis to the shin, can cause inflammation and sharp pain. Hill running, greater-than-normal mileage and weak glute muscles can all contribute to the syndrome. Stretches specific to the IT band area and strengthening the hips and glutes are important to recovery.

Stress fracture. When muscles become fatigued from overuse, they can no longer absorb shock properly. A tiny crack can form in the bone, most often the tibia in the shin or the foot’s long metatarsal bones, causing severe pain and reduced mobility. X-ray cannot always detect the fracture and a bone scan might be needed. Rest — no impact sports — is critical to recovery, which can take several weeks or even months.

Source: American Academy of Orthopaedic Surgeons

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